Tyler Knight shares some Soccer Specific Return To Play or RTP tips and tricks. With nearly a decade of soccer experience, he has seen a lot of growth in sport-specific rehab plans.
What is the least soccer specific rehab exercise you have seen?
Almost everything we do…discuss the importance of understanding the ‘why’ of what we do, as well as never forgetting components of movement.Isometrics because the patient can’t perform much more Eccentrics once ableStretch-shortening cycleUnloaded → supported → unsupported“Train movement not muscles”
What do we need to consider in on-field RTP?
In order to get to the field, you have to get out of the Athletic Training room first. Treat the person, not the athlete or the injury (reference all that people have going on in their lives). Ron Corson-ismGood communication, setting expectations, and appropriate planning are MUSTs.Individualization (based on person, position, and injury)Consider our two biggest protective capacities and build upon those early: strength and enduranceProgramming based upon working zones (importance of ESD)Quantifying internal vs. external loadTo do that, we have a few basic rules at Charlotte FC:1. Create a safe environment.
2. Don’t hurt the person.
3. Be aggressive without breaking rules 1 and 2.
KPIs to provide direction and accountability to the processAdditional principles of rehab to accelerate and enhance what we do on the field:Move early, move often.Highlight BFR and isometrics.Don’t mess it up.Consider tissue healing times.Periodize manual therapies, incorporate things the person believes inBreak down the phases of healing (acute, subacute, remodeling), as well as the places of healing: table, Athletic Training room, gym, field, and everything in between.Create time for mental or psychological recoveryKPIsMobilityStabilityFunctionPowerOn-FieldConsider position, individual needs, team tactics, and demands of the sport…and MAKE IT FUNPlayers have the ball only 3% of the time, a good reason to emphasize the incorporation of the ball and fitness/drill exercises that place focus on getting into the right spacesIn 2019/2020 EPL season, the highest average number of passes per game was 688 (Man City; approx 62. per player) and the least was Burnley at 333 (approx. 30 per player).Paul Bradley researchConsider control – chaos continuumReverse engineer and use the prospective loading documentWhen we have elevated AC ratios, did the majority of that come from a more controlled environment or chaotic environmentBy using fatigue, you can increase chaos (for those athletes limited in what they can perform)How are you going to account for one of the most unique facts of the game: limited substitutions and, potentially like many other sports, the pace of the game is only increasingActual loadingLink load with the context of how it happens in a session/matchTD, HSR, sprint, ACC/DEC, HMLD or explosive effortsIntensive vs. extensive days (can you match what the player is doing with you to what the team is doing; team schedule, RPExduration)Density of high intensity actions (repeated sprint ability and repeated high intensity efforts in 1, 3, and 5 min blocks)In the secondary setting, we may not be out on the field for practice. How can we help coordinate RTPs?
“It takes a village.” Educate, incorporate, and empower those around you. If we all understand the why, we will know how to do it, and what we need to use to get there. Trust is a major factor here.Create a PowerPoint document, have illustrations, don’t be afraid to do the math ahead of time, use a stopwatch.Let’s talk through a RTP plan you use and why:
The war is won and lost in the mindBriefly recap where we are and where we’re goingWhat can we do to prepare, potentiate, desensitize, or address other movement qualities before we hit the pitch; build time and trust with peopleIndividualization:Needs assessment to construct rehab or movement plan:Current injuryPrevious hx of injuryQuality of movement (identify areas to fine-tune)Training history (gym)Movement and ability restorationMajor proponent of push-pull movements or complex training (plyo-like), also appreciate avenues to incorporate lumbopelvic hip stability (core transferring F)External loadAverage weekly load in trainingAverage match loadThese are BUDGETS, it’s science AND artIf they aren’t close to being on the field, what are we going to do to reduce that gap (RPE x duration; off legs conditioning, gym, etc.)On-Field4 levels1: high controlBand 1 ACC/DEC, no HSR/sprint2: medium controlBand 2 ACC/DEC, add HSR, no sprint3: low control to low chaosBand 3 ACC/DEC; add sprint 4: medium to high chaosAdd density to exposuresDrill selectionTechnicalTactical/passingPosition specific**all interspersed with position specific running**MAS, ASR, or loading focusedHow can we get players out of rehab the same care and joy others get from playing the gameRevisit the plan often to show progressChange the settingMake it fun, do what you can with themWeekMonday: introductory dayTuesday: small to medium spaceWednesday: large spaceThursday: treatment onlyFriday: small to medium space day, slightly more than re-introSaturday: super-SaturdaySunday: OFFTyler – [email protected]
Jeremy – @MrJeremyJackson
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